| Avalon Dental Center, Inc | |
|
9614 Pennsylvania Ave Upper Marlboro MD 20772-3670 | |
| (301) 599-0404 | |
| (301) 599-1620 |
| Full Name | Avalon Dental Center, Inc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 9614 Pennsylvania Ave, Upper Marlboro, Maryland |
| Authorized Official Name and Position | Mofolusara O Ogunfusika (DENTIST) |
| Authorized Official Contact | 3015990404 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avalon Dental Center, Inc 9614 Pennsylvania Ave Upper Marlboro MD 20772-3670 Ph: (301) 599-0404 | Avalon Dental Center, Inc 9614 Pennsylvania Ave Upper Marlboro MD 20772-3670 Ph: (301) 599-0404 |
| NPI Number | 1407629173 |
|---|---|
| Provider Enumeration Date | 11/03/2023 |
| Last Update Date | 11/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407629173 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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